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2型糖尿病患者的死亡率和累积心血管风险因素控制:全国性基于人口的队列研究
Zenglei Zhang1,2, Chunqi Wang1, Xingyu Zhou1,2
1National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
保持对心血管风险因素的控制可以显著降低2型糖尿病患者的死亡率. 持续控制饮食,运动和血压等因素对于长期生存至关重要.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 对2型糖尿病 (T2D) 患者来说,控制心血管风险因素至关重要.
- 大多数证据依赖于基线测量,限制了对动态风险因素管理的理解.
- 随着时间的推移,变化和累积控制对T2D死亡率的影响仍未得到充分研究.
研究的目的:
- 研究T2D患者心血管风险因素和死亡率的变化与累积控制之间的关联.
- 评估持续与降低风险因素控制对所有原因和心血管疾病 (CVD) 死亡率的长期影响.
主要方法:
- 来自中国HEART项目的138,193名T2D患者 (年龄在35-75岁之间) 的分析.
- 风险因素的评估:吸烟,饮食,体育活动,血压,胆固醇,葡萄糖和BMI.
- 累积控制以时间加权平均值 (TWA) 衡量;通过比较基线和后续控制水平来评估变化.
主要成果:
- 对6~7个风险因素的累积控制较高,与所有原因死亡率显著降低相关 (HR:0.43).
- 与稳定的低控制相比,改善的风险因素控制降低了死亡率 (HR:0.86).
- 在TWA风险因素控制中,最高四分位数的死亡率 (HR:0.53) 比最低四分位数低47%.
结论:
- 持续和累积的心血管风险因素控制大大降低了T2D的死亡率.
- 持续的风险因素管理对于改善T2D患者的生存率至关重要.
- 调查结果强调了可修改的风险因素的动态,持续管理的重要性.
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